What is GERD (acid reflux)? - Gastroesophageal reflux disease, commonly referred to as GERD or acid reflux, is a condition in which the liquid content of the stomach regurgitates (backs up or refluxes) into the esophagus. The liquid can inflame and damage the lining (cause, cause esophagitis) of the esophagus although visible signs of inflammation occur in a minority of patients. The regurgitated liquid usually contains acid and pepsin that are produced by the stomach. (Pepsin is an enzyme that begins the digestion of proteins in the stomach.) The refluxed liquid also may contain bile that has backed-up into the stomach from the duodenum. (The duodenum is the first part of the small intestine that attaches to the stomach.) Acid is believed to be the most injurious component of the refluxed liquid. Pepsin and bile also may injure the esophagus, but their role in the production of esophageal inflammation and damage is not as clear as the role of acid.  Read More

Video: What Is Gastrointestinal Reflux Disease?

Video: Heartburn and Acid Reflux Testing - Endoscopy

What causes GERD? - The cause of GERD is complex. There probably are multiple causes, and different causes may be operative in different individuals, or even in the same individual at different times. A small number of patients with GERD produce abnormally large amounts of acid, but this is uncommon and not a contributing factor in the vast majority of patients. The factors that contribute to GERD are the lower esophageal sphincter, hiatal hernias, esophageal contractions, and emptying of the stomach.  Read More

What are the symptoms of uncomplicated GERD? - The symptoms of uncomplicated GERD are primarily heartburn, regurgitation, and nausea. Other symptoms occur when there are complications of GERD and will be discussed with the complications.  Read More

How is GERD diagnosed and evaluated? — The usual way that GERD is diagnosed—or at least suspected—is by its characteristic symptom, heartburn. Heartburn is most frequently described as a sub-sternal (under the middle of the chest) burning that occurs after meals and often worsens when lying down. To confirm the diagnosis, physicians often treat patients with medications to suppress the production of acid by the stomach. If the heartburn then is diminished to a large extent, the diagnosis of GERD is considered confirmed. This approach of making a diagnosis on the basis of a response of the symptoms to treatment is commonly called a therapeutic trial.  Read More

How is GERD treated? — One of the simplest treatments for GERD is referred to as life-style changes, a combination of several changes in habit, particularly related to eating.  Read More

What is a reasonable approach to the management of GERD? — There are several ways to approach the evaluation and management of GERD. The approach depends primarily on the frequency and severity of symptoms, the adequacy of the response to treatment, and the presence of complications. Read More

What are the unresolved issues in GERD? - The cause of GERD is complex. There probably are multiple causes, and different causes may be operative in different individuals, or even in the same individual at different times. A small number of patients with GERD produce abnormally large amounts of acid, but this is uncommon and not a contributing factor in the vast majority of patients. The factors that contribute to GERD are the lower esophageal sphincter, hiatal hernias, esophageal contractions, and emptying of the stomach.  Read More

What are the unresolved issues in GERD? - The cause of GERD is complex. There probably are multiple causes, and different causes may be operative in different individuals, or even in the same individual at different times. A small number of patients with GERD produce abnormally large amounts of acid, but this is uncommon and not a contributing factor in the vast majority of patients. The factors that contribute to GERD are the lower esophageal sphincter, hiatal hernias, esophageal contractions, and emptying of the stomach.  Read More

What is gastroesophageal reflux surgery ? - Gastroesophageal reflux surgery is typically performed in patients with serious gastroesophageal reflux disease that does not respond to drug therapy. Gastroesophageal reflux is classified as the symptoms produced by the inappropriate movement of stomach contents back up into the esophagus. Nissen fundoplication is the most common surgical approach in the correction of gastroesophageal reflux. The laparoscopic method of Nissen fundoplication is becoming the standard form of surgical correction. Read More

What is gastroenterologic surgery ? - Gastroenterologic surgery includes a variety of surgical procedures performed on the organs and conduits of the digestive system. These procedures include the repair, removal, or resection of the esophagus, liver, stomach, spleen, pancreas, gallbladder, colon, anus, and rectum. Gastroenterologic surgery is performed for diseases ranging from appendicitis, gastroesophageal reflux disease (GERD), and gastric ulcers to the life-threatening cancers of the stomach, colon, liver, and pancreas, and ulcerative conditions like ulcerative colitis and Crohn's disease. Read More